Category Archives: Medicare

Increased Rx use offsets medical services costs in Medicare

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Analysis shows a link between changes in Rx drug use and changes in the use of and spending for medical services.

Analysis shows a link between changes in Rx drug use and changes in the use of and spending for medical services.

A new report by The Congressional Budget Office (CBO) recognizes the effect of medicines in offsetting medical services costs for people with Medicare.

Based on their analysis of the costs and use of prescription drugs and other medical services covered through Medicare, the CBO plans to incorporate the offsetting savings associated with prescription drug use in budget estimates of policies affecting Medicare.

Going forward, CBO will assume that any policy that would result in a 1 percent increase in the number of prescription drugs filled in Medicare would correspondingly decrease the spending on medical services in the program by 0.2 percent.

“Previously, when estimating the budgetary effects of legislation regarding prescription drugs, CBO found insufficient evidence of an “offsetting” effect of prescription drug use on spending for medical services” said CBO. “But recently, more analysis has been published that demonstrates a link between changes in prescription drug use and changes in the use of and spending for medical services.”

The CBO has confirmed that this change will only affect those involved with the Medicare program. Further research is necessary to determine whether or not such an offset would be beneficial to other programs such as Medicaid.

To read more on this topic:

  • The CBO report, “Offsetting Effects of Prescription Drug Use on Medicare’s Spending for Medical Services,” is available online here.
  • This blog post by the Pharmaceutical Research and Manufacturers of America (PhRMA) said that this historic change to CBO methodology represents a significant step forward in evaluating health care policy and reaching common goals of better outcomes and lower costs.
  • An op-ed by a Wisconsin aging advocate examines some of the potential changes to the Medicare prescription drug benefit currently being debated.
  • AstraZeneca’s most recent posts on Medicare may be found here and here.

2013 Medicare premiums steady as open enrollment begins

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Time to talk Medicare: Open enrollment begins on October 15 and runs through December 7.

It’s that time of year again – open enrollment period for the Medicare program, allowing seniors and other beneficiaries to review, compare and update their health choices, including their prescription drug benefit.

Open enrollment begins today and lasts through Dec. 7.

And there’s good news for beneficiaries as they pick their plan: The Centers for Medicare & Medicaid Services says the average monthly Medicare prescription drug premium for 2013 will be $30 – virtually unchanged for the past three years and 50 percent lower than initial projections.

Since 2006, the Medicare prescription drug program has delivered market-based competition into government healthcare offerings for prescription drug coverage. These plans compete to deliver affordable coverage for beneficiaries and value for taxpayers.

And they have proven to be very popular.

As we discussed here, the 2012 Medicare Today beneficiary satisfaction survey found that overall satisfaction with the Medicare prescription drug benefit has increased from 78 percent to 90 percent since the program was first implemented. More than 40 million people with Medicare (90 percent of all beneficiaries) now have the option of comprehensive prescription drug coverage, which helps provide high-quality and high-value healthcare for America’s seniors.

We encourage Medicare beneficiaries to take the time to find the plan that is best for them and their health needs. There are many useful resources available to help enrollees evaluate coverage options and make informed decisions. People with Medicare can call 1-800-MEDICARE or visit https://www.medicare.gov/find-a-plan/ for more plan information.

Another helpful resource is My Medicare Matters, led by the National Coalition on Aging, that has a consumer-friendly Web site that takes one step by step through the decision-process and includes links to specific sections of the Medicare.gov website.

Seniors satisfied with Medicare prescription drug program

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Seniors overwhelmingly approve of the Medicare prescription drug benefit.

Medicare Today released its 2012 beneficiary satisfaction survey results Wednesday, providing additional evidence that the Medicare prescription drug benefit offers seniors affordable, effective access to the medicines they need.

The survey found that overall satisfaction with the benefit known as Part D has increased from 78 percent to 90 percent since the program was first implemented.

With 90 percent beneficiary satisfaction and average monthly premiums remaining virtually unchanged over the past three years, Medicare Part D is working for seniors and helping our government control costs by reducing healthcare system spending. More than 40 million people with Medicare (90 percent of all beneficiaries) now have the option of comprehensive prescription drug coverage, which helps provide high-quality and high-value healthcare for America’s seniors.

The survey also found that:

  • 90 percent of Part D enrollees are satisfied with their coverage and 96 percent say their coverage works well.
  • 61 percent of seniors reported that they would be unable to fill all of their prescriptions without Part D.
  • More than 8 in 10 seniors report that their plan is predictable, affordable, reasonable and offers good value.

The survey, which can be viewed in full here, is growing evidence that seniors’ access to prescription medicines through the Medicare program is improving health outcomes and lowering costs.

Congress Should Repeal IPAB

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Congress should approve HR 452.

AstraZeneca is urging Congress to support legislation sponsored by Rep. Phil Roe that would repeal the Independent Payment Advisory Board (IPAB) established by the health reform law.

IPAB would have the authority to cut Medicare spending if spending exceeds specified targets. As created, implementation of IPAB’s recommendations is exempt from both judicial and administrative review and is fast-tracked through Congress.

IPAB’s virtually unchecked authority to cut Medicare spending represents a clear threat to patient care.

Without real congressional oversight, the board has the power to reduce Medicare spending at the expense of patients’ health and future breakthroughs in treatment.

Why?

A federal entity focused solely on cost-cutting measures is more likely to view innovative new therapies as problems instead of solutions.

That, of course, is not the case, and it is a shortsighted approach to cost control. New medicines can be part of the solution to our health care problems, as research shows that medicines can hold down costs in other health care areas.

IPAB sets a bad precedent by allowing for a board’s decisions to essentially go into effect without oversight. The manner in which IPAB was designed makes it nearly impossible for Congress to override IPAB recommendations.  Even more disconcerting is the fact that the implementation of IPAB decisions cannot be challenged in court, therefore Americans will have no way to appeal the board’s decisions.

Simply put, IPAB wrongly puts control over Medicare in the hands of unelected, unaccountable federal officials.

Repealing IPAB would ensure that seniors and Congress continue to have control over Medicare. For that reason, Congress should approve HR 452.

Update: The House Ways and Means Committee just passed by voice vote legislation to repeal IPAB. Earlier this week, the House Energy and Commerce Committee passed the IPAB repeal bill by voice vote as well. Action by the full House of Representatives is expected the week of March 19.

Seniors and the donut hole

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American seniors have increased access to medicines via the Medicare prescription drug program.

The Medicare prescription drug benefit for seniors and the disabled is saving them money while helping them get the medicines they need, even if they’ve reached the coverage gap, the Associated Press found:

“WASHINGTON (AP) – Medicare’s prescription coverage gap is getting noticeably smaller and easier to manage this year for millions of older and disabled people with high drug costs.

“The “doughnut hole,” an anxiety-inducing catch in an otherwise popular benefit, will shrink about 40 percent for those unlucky enough to land in it, according to new Medicare figures provided in response to a request from The Associated Press.

“The average beneficiary who falls into the coverage gap would have spent $1,504 this year on prescriptions. But thanks to discounts and other provisions in President Barack Obama’s health care overhaul law, that cost fell to $901, according to Medicare’s Office of the Actuary, which handles economic estimates.

“A 50 percent discount that the law secured from pharmaceutical companies on brand name drugs yielded an average savings of $581. Medicare also picked up more of the cost of generic drugs, saving an additional $22. The estimates are averages, so some Medicare recipients may do worse and others better.”

The AP’s findings are important in light of a study that found patients who enter the “donut hole” or coverage gap are twice as likely to discontinue their medications as they are to switch to more affordable or generic medications.

Need further evidence that the Medicare prescription drug benefit is working well?

–Five years into the Medicare prescription drug program, an overwhelming majority – 88 percent – of America’s seniors and disabled are satisfied with their prescription drug coverage

–Medicare Part D beneficiaries’ premiums did not increase from 2011 to 2012

–American seniors’ increased access to medicines via the Medicare prescription drug program led to reduced spending on post-acute care such as hospitals and nursing homes

Today, more than 29 million Medicare beneficiaries are enrolled in a Part D plan, and 90 percent of all beneficiaries have comprehensive drug coverage. AstraZeneca believes the Medicare Part D program is a model for how the private sector and public sector can work together to provide critical access to medicines that improve our nation’s health.

Seniors satisfied with Medicare prescription drug program

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The Medicare prescription drug benefit is working well for America’s seniors.

A new survey of seniors by the Medicare Today coalition provides additional evidence that the Medicare prescription drug benefit offers seniors affordable, effective access to the medicines they need.

Five years into the Medicare prescription drug program, an overwhelming majority – 88 percent – of America’s seniors and disabled are satisfied with their prescription drug coverage.

Today, more than 29 million Medicare beneficiaries are enrolled in a prescription drug benefit plan, and 90 percent of all beneficiaries have comprehensive drug coverage.

Of these beneficiaries, the survey found that:

–Nearly 80 percent of seniors say they have lowered their drug spending, an increase of eight percentage points from when the program started.

–Compared to other subgroups, low income beneficiaries and dual eligibles (beneficiaries eligible for both Medicaid and Medicare) show the highest satisfaction rate with their drug coverage – 90 percent of dual eligibles are satisfied with their coverage and for those beneficiaries earning $15,000 or less in income, 96 percent are satisfied.

–Large majorities of respondents say that the program is delivering good value, and they would recommend it to their peers. Further, 95 percent of respondents say their plan is working well.

And, as we explain here, there is growing evidence that seniors’ access to prescription medicines through the Medicare program is improving health outcomes and lowering costs.

Visit the Medicare Today website to view the entire survey.

2012 Medicare open enrollment comes early

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Medicare’s open enrollment period is just two days away – are you ready? Whether you are a beneficiary, a caregiver or know someone who is, you can help spread the word about Medicare open enrollment and where people can find information and help.

What’s different about this year is that the timeframe for open enrollment begins earlier – on October 15 – and ends earlier – on  December 7.  This adjustment was made to help ensure beneficiaries may have continuous coverage through January 1 with minimal disruption.

Beneficiaries will have seven weeks to explore new medical and prescription drug coverage options and select the plans that work best for them. There are many useful resources available to help enrollees evaluate coverage options and make informed decisions.

The Centers for Medicare & Medicaid Services (CMS) Medicare Plan Finder tool is now uploaded with 2012 plan information. Plan Finder allows you to search and compare compare health plans, policies and prescription drug coverage options in your area. According to CMS, the Plan Finder had 280 million page views last year.

Another helpful resource is My Medicare Matters, led by the National Coalition on Aging, that has a consumer-friendly Web site that takes one step by step through the decision-process and includes links to specific sections of the Medicare.gov Web site.

Since 2005, My Medicare Matters has supported over 4,500 people navigate through Medicare enrollment through their “Ask the Expert” service, as well as recommendations to other local resources that offer enrollment support within one’s community.

Because plan options and personal health needs change each year, it’s important to take the time to review the 2012 the options carefully. Resources like these can make that process easier for beneficiaries and caregivers.

As we wrote about here, Medicare Part D provides critical access to medicines for America’s seniors, and helps save money on other health care costs.

The Medicare prescription drug benefit works

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AstraZeneca is focused on the success and value of the Medicare prescription drug benefit to patients.

Today, more than 29 million Medicare beneficiaries are enrolled in a Part D plan, and 90 percent of all beneficiaries have comprehensive drug coverage. Polls have consistently shown that Medicare Part D enrollees are overwhelmingly satisfied with their coverage.

The above video from PhRMA explains why the program is so successful.

For more resources on Medicare Part D, visit http://www.phrma.org/issues/medicare.

Former HHS Secretary: Medicare drug benefit is working

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Former HHS Secretary Tommy G. Thompson says the Medicare drug benefit is working for patients.

Former US Department of Health and Human Services Secretary Tommy G. Thompson took the time to answer a few questions from PhRMA about the Medicare prescription drug benefit, which was enacted during his time in office.

In short, he says, the program is working for patients.

My early experience is that the prescription drug benefit is working as we thought it would. Seniors are satisfied with the program. For the first time, seniors are getting meaningful prescription drug assistance.

There was concern raised that there were too many choices, and seniors wouldn’t be able to understand those choices. That concern is not playing out. Seniors are getting adequate information, and are able to make choices in their best interests. Just as we thought, acting in their best interests creates a market dynamic that keeps the program cost lower than what we even initially projected.

Later, Thompson discusses whether changes are needed to the program.

You are always going to see policymakers want to make adjustments to the program, but major adjustments could disrupt the market and increase costs. In this fiscal environment, why would you take a program that is working to push down prices and risk decreasing its effectiveness? Rather than change Part D, I would apply the lessons learned to other aspects of the Medicare program.

As Thompson mentioned, here’s growing evidence that access to prescription medicines through Medicare Part D is reducing costs throughout the system and improving health for seniors. For example, American seniors’ increased access to medicines via the Medicare prescription drug program led to reduced spending on post-acute care such as hospitals and nursing homes.

One change being made under the health reform law signed by the president last year closes part of the coverage gap that seniors pay once their prescription drug costs reach a certain level. As part of its support for health care reform legislation, the pharmaceutical industry agreed to cut out-of-pocket costs on brand name medicines by 50 percent for Medicare patients who reach the coverage gap – known as the “donut hole.”

AstraZeneca also provides support to Medicare patients who need help paying for our medicines through our prescription savings programs. Click here to learn more about this program and whether AstraZeneca may be able to help you or your family save on your prescription drug costs.

Filling the donut hole: why it matters

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A new study of the Medicare prescription drug benefit found that patients who enter the “donut hole” or coverage gap are twice as likely to discontinue their medications as they are to switch to more affordable or generic medications.

The study conducted by researchers from Harvard University, Brigham and Women’s Hospital and CVS Caremark suggests that Medicare Part D enrollees who have to bear the full cost of their medications are less likely to take their medicines as prescribed by their health care professionals.

“The resulting decrease in medication adherence could ultimately result in higher medical costs as a result of adverse health events,” said Jennifer M. Polinski, lead author of the study.

Annual excess health care costs due to medication non-adherence in the U.S. are estimated to be as much as $300 billion annually, according to CVS Caremark.

But there’s good news.

Efforts are underway to help those in Medicare Part D get the medicines they need, even as they go through the coverage gap.

As part of its support for health care reform legislation, the pharmaceutical industry agreed to cut out-of-pocket costs on brand name medicines by 50 percent for Medicare patients who reach the coverage gap.

And there’s growing evidence that seniors access to prescription medicines through Medicare Part D is improving health outcomes and lowering costs.

Earlier this year the Centers for Medicare & Medicaid Services (CMS) posted data that shows beneficiaries in the Medicare prescription drug program are accessing the medicines they need and saving money as they reach the coverage gap in the Part D benefit design.

American seniors’ increased access to medicines via the Medicare prescription drug program led to reduced spending on post-acute care such as hospitals and nursing homes.

AstraZeneca also provides support to Medicare patients who need help paying for our medicines through our prescription savings programs. Click here to learn more about this program and whether AstraZeneca may be able to help you or your family save on your prescription drug costs.